In the 2016 update of the World Health Organization (WHO) classification of hematopoietic neoplasms, -like B-acute lymphoblastic leukemia/lymphoma (B-ALL) is added as a new provisional entity that lacks the translocation but shows a pattern of gene expression very similar to that seen in B-ALL with .
To review the kinase-activating alterations and the diagnostic approach for -like B-ALL.
We provide a comprehensive review of -like B-ALL based on recent literature and the 2016 update of the World Health Organization classification of hematopoietic neoplasms.
Several types of kinase-activating alterations (fusions or mutations) are identified in like B-ALL. The main categories are alterations in the ABL class family of genes, encompassing (rare), and colony-stimulating factor 1 receptor () fusions, or the JAK2 class family of genes, encompassing alterations in , and other genes in this pathway. These alterations determine the sensitivity to tyrosine kinase inhibitors. As a wide variety of genomic alterations are included in this category, the diagnosis of -like B-ALL is extremely complex. Stepwise algorithms and comprehensive unbiased testing are the 2 ways to approach the diagnosis of -like B-ALL.